The Great Debate: Clomid versus Femara

Block or Fool?

Femara and Clomid are both prescription drugs. Femara, or letrozole, was developed to treat breast cancer in postmenopausal women and is part of a family of drugs known as aromatase inhibitors. It serves to block estrogen production. Clomid (clomiphene citrate) is a drug that was developed to treat ovulatory dysfunction. This drug tricks the body's estrogen receptors into thinking that estrogen levels are low. When the body fails to produce estrogen or the body is fooled into thinking that estrogen levels are lower than they really are, a process is set in motion that induces ovulation.

Clomid Resistance

While Femara has only been in use as an infertility treatment since 2001, it has been shown to be just as effective as Clomid if not more so, depending on who needs the treatment. Many women have found that Femara worked when Clomid failed to produce the desired results. There have been quite a few small-scale studies comparing the two drugs as infertility treatments. Some studies suggest that Clomid is more effective while others showed results that tipped the scales in favor of Femara. Perhaps most persuasive are the few studies that showed Femara to be more effective in cases of Clomid resistance.

Then, too, there is the fact that Femara seems to have fewer side effects than Clomid; which can cause vaginal dryness and thinning of the uterine lining. These side effects are the main reason that women who ovulate with Clomid don't always go on to conceive. The texture of the cervical mucus and the status of the uterine lining both have a direct affect on the body's ability to conceive.

On the other hand, most physicians are more comfortable with the idea of prescribing Clomid, since Femara is not approved by the FDA as an infertility drug and its use in this manner is still considered off label. It bears mention that Clomid has been studied in a very thorough manner and has been available for decades, even in generic form. Clomid is also much less expensive than Femara.

Femara can be viewed as a promising infertility treatment that may be worthy of consideration in situations where Clomid has failed to perform. It also pays to consider that Clomid remains in the body long after dosing, which increases the chance that the drug might affect not only the cervical mucus and uterine lining, but an early, developing embryo, as well. Femara leaves the body almost as soon as it is absorbed.

However, birth defects are also possible when using Femara. Novartis, the manufacturer of Femara, found that of 13 pregnant women who used Femara, two had children with birth defects. The drug is labeled with a warning of its association with a higher risk of birth defects when used in pregnancy. Novartis has not sought FDA approval to market Femara for any purpose outside of breast cancer treatment and prevention. This is believed to be a precautionary measure against liability.

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LaleeIf Femara leaves your system in 24 hours and you take it before you ovulate, then how could it cause birth defects? I can see how it could cause problems if the Femara was in your system during conception, but I'm confused as how it causes birth defects if it is not in your system during the time of conception. Usually, Femara is taken during cycle days 3-7, before ovulation takes place (to induce the ovulation itself). Any clarity in this would be great.